Individual provider Active NPI

Stephanie Lukevich

  • Student in an Organized Health Care Education/Training Program
  • Savannah, GA
National Provider Identifier
1154839157
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
PHI-019494 Issued in GA
Practice address
5500 Abercorn St
Savannah, GA 31405-6913
NPI assigned
Jan 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X PSI37938 FL
Student in an Organized Health Care Education/Training Program 390200000X PHI-019494 GA Primary

Addresses

Primary practice location

5500 Abercorn St
Savannah, GA 31405-6913

Mailing address

9205 Tennyson LN
Savannah, GA 31405-0347
Phone (850) 217-3684

Other practice location 1

725 Grand Blvd
Miramar Beach, FL 32550-7873
Phone (850) 217-3684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PSI37938FLMDStudent in an Organized Health Care Education/Training Program
PHI-019494GAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154839157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 TENNYSON LN",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314050347",
            "telephone_number": "850-217-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 ABERCORN ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Miramar Beach",
            "state": "FL",
            "postal_code": "325507873",
            "country_code": "US",
            "telephone_number": "850-217-3684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKEVICH",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PSI37938",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "PHI-019494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.